Physical therapy may be good as surgery for back problems

A study from the University of Pittsburgh concludes that physical therapy may be as effective as surgery for treating lumbar spinal stenosis as surgery–a common cause of nerve damage and lower back pain in older adults.

The condition results from a compression of open spaces in the lower spinal column. It can lead to pinched nerves, tingling, and weakness in the lower back and extremities.

From 2000 to 2005, the researchers asked people who had agreed to surgery to join the study that would randomly place them into either physical therapy or surgery. Out of this, 169 participants agreed and, in the end, 87 had surgery and 82 did physical therapy.

In the beginning of the study, participants had to be at least 50 years old, able to walk a quarter of a mile without difficulty, and have no underlying medical conditions. The majority, however, were sedentary and typically obese. Participants in the surgery group were 67 years old on average, and participants in the physical therapy group were 70 years old on average.

The physical therapy sessions were twice a week for six weeks. Participants had the option to opt out for surgery at any point, which 57 percent eventually did after two years. Regardless of the group they were in, participants achieved similar pain and symptom reduction over two years.

Based on the findings, the researchers suggested that both options could bring similar results and recommended that people turn to physical therapy before resorting to surgery.

Drug-resistant bug spreading in U.S.

A new strain of an intestinal bug that’s resistant to multiple drug has entered the U.S. through travelers and has caused a series of diarrhea outbreaks, according to a report from the Centers for Disease Control and Prevention (CDC).

The bacteria Shigella often occurs when people travel to underdeveloped countries and can cause a nasty bout of diarrhea. The CDC says a new strain of this bug that is resistant to the antibiotic ciprofloxacin (Cipro) infected 243 people in 32 states and Puerto Rico between May 2014 and February 2015. Previously, resistance to Cipro occurred in only two percent of Shigella cases. Now, the CDC reports, the latest version of the bug is resistant to Cipro 90 percent of the time. Cipro is normally the go-to treatment for this infection. The bacteria had already become resistant to the antibiotics ampicillin and trimethoprim/sulfamethoxazole.

The Shigella bacteria are often found in stool-contaminated water used to wash and irrigate crops. The CDC points out that childcare facilities, homeless people, and gay men are most susceptible to spreading of the bacteria. About half the cases, it said, originated from the Dominican Republic, India, or other place outside the U.S.

The CDC recommends practicing proper hygiene, and emphasizes the importance of thorough and frequent handwashing.

Which weight loss programs are effective?

Weight Watchers and Jenny Craig may be the most effective programs for keeping weight off over the course of a year, according to an analysis of commercial weight loss programs done at Johns Hopkins University.

Researchers looked at 39 published studies on 11 weight-loss programs that evaluated the effectiveness of the program and were long-term randomized controlled trials. The studies had to be 12 weeks long and the programs had to be comprehensive to be included in the analysis, meaning they also involved both nutrition and behavioral counseling or social support, but didn’t necessarily emphasize physical fitness. The 11 programs studied were Weight Watchers, Jenny Craig, Nutrisystem, Health Management Resources (HMR), Medifast, Optifast, Atkins, Slimfast, The Biggest Loser Club, eDiets, and Lose It!

The findings, published in the journal Annals of Internal Medicine, revealed that only people who participated in Weight Watchers and Jenny Craig achieved significant weight loss and sustained that weight loss over the year. Jenny Craig participants lost an average of 4.9 percent more weight and Weight Watchers participants lost an average of 2.6 percent more weight compared to people who did not enroll in a program and tried to diet on their own. Nutrisystem showed promise early on with participants losing 3.8 percent more weight in the first three months compared to people who did not participate. However, there was not enough sufficient evidence to determine how well this weight loss would be sustained by participants in the long term.

The researchers said that although dieters in even the most effective weight loss plans experienced only modest weight loss–3 to 5 percent after 12 months–that’s still an important first goal to reach.